End of Life

Although thinking about death can be painful for you and your loved ones, knowing what to expect at the end of life can help you navigate the practical issues and emotional road ahead.

Get Your Legal Documents TogetherTalk to your doctor about medical decisions you may need to make and what medical interventions those scenarios might require. Then decide what’s best for you. There are important steps you can take in advance to document your healthcare desires. A very common option is to create an advance directive, also called a living will.

Spelling out your wishes ahead of time takes the burden off your family members, said Barry J. Jacobs, Psy.D., a clinical psychologist in Springfield, Pa., and author of The Emotional Survival Guide for Caregivers. “Even in a horrible situation, having a living will can be a blessing because your family members know which treatments you do and do not want to receive,” Jacobs said.

In addition, some people appoint a healthcare proxy in a document called durable power of attorney for health care. It’s important to share your wishes for medical care with your healthcare proxy, so he or she can make medical decisions for you when you can’t.

How Hospice Care Can HelpHospice care provides comfort and support to heart and stroke patients and their families, with a focus on quality of life. Services are often provided in the home by a team that includes a doctor, nurse, therapist, social worker and other professionals. Hospice care services may include:

Medical care to relieve symptoms

Emotional and spiritual counseling

Art therapy, music therapy and other therapies

Respite care to provide a break for caregivers and families

Home health aides to help with bathing, grooming, eating and other personal health needs

Help with insurance, legal documents and other practical issues

Assistance from trained volunteers who provide support services like babysitting, running errands and preparing meals

Bereavement support and counseling for caregivers and families

Coping With End of Life It’s normal to feel scared, sad or even angry as you near the end of life. You may feel guilty for leaving family and friends behind. You may grieve the loss of independence and mobility or mourn for the life you had planned. Here is some advice to help cope with those emotions and bring a sense of completion to your life:

Say the things that matter most. It could be, “I love you, I’m thankful for the time I’ve had with you and I’m going to miss you.” Being able to say “goodbye” and “thank you” matters tremendously for both patients and loved ones, Jacobs said. “This may also be a time to provide forgiveness to one another as much as possible for things that happened in the past.”

Share stories. Tell your children, grandchildren and other family members about their family history. These stories are family heirlooms you can pass down to future generations. You can also record these stories or write them down.

Perform a life review. Look back on your life and celebrate the people you love, the things you accomplished and the difference you made in other people’s lives. “Taking time to reflect allows people to hopefully come away with an appreciation for their life and gives them a greater sense of peace with themselves,” Jacobs said.

Have a meaningful experience. Maybe there’s a place where you always wanted to travel, or a favorite book you want to reread. You can also plan a way to spend time with the people who matter most to you. Jacobs recalled a patient who had a dinner party where everyone the patient cared about was together. “There was a lot of laughter and joy, but also a lot of recollection about life,” Jacobs said. “It was something the patient really enjoyed prior to dying and something the family and loved ones can still look back on.”

Coping With the Loss of a Loved One Sorting out the emotions of grief and loss can be difficult. Jacobs, an American Heart Association spokesperson on family caregiving, offers this advice for coping with the loss of a loved one:

Attend your loved one’s funeral. Funerals allow family members and other loved ones the opportunity to grieve together. “Because everyone is together, it underscores that the family is going to endure,” Jacobs said.

Be patient with yourself and the grieving process. People almost universally underestimate how long it will take them to grieve. “When you’re close to someone, you can grieve for months, maybe years,” Jacobs said.

Create a ritual. Engaging in a ritual, such as celebrating your loved one’s birthday or honoring your loved one on the death anniversary, can help you heal.

Take care of yourself. Grieving can sometimes cause loved ones to neglect their own health. It is important to eat well, stay physically active and take time to do the things you enjoy.

Find your new identity. For long-term caregivers, their identity often becomes wrapped up in caregiving. Find something new to become passionate about. Take an art class, start swimming or doing yoga, or volunteer at a local hospital.

Get support. It’s normal to be sad, angry and in pain after a loved one dies. You may consider joining a bereavement support group to receive comfort and guidance from others who have lost a loved one. You may even need professional help. “When people become so sad that they’re unable to function, the sadness may have tipped them into a depression,” Jacobs said. If so, talk to your primary doctor first.